Atrius India Core FHIR Implementation Guide
0.1.0 - ci-build
Atrius India Core FHIR Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft as of 2026-07-14 |
{
"resourceType" : "PlanDefinition",
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🔗 "http://hl7.org/fhir/StructureDefinition/cdshooksserviceplandefinition|4.0.1"
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},
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"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Heart Failure Admission Protocol</b> (<code>clinical-protocol</code>). See <code>Library/AtriusHFAdmission</code> for applicability expressions and <code>Questionnaire/hf-admission-eligibility</code> for the ED gate.</p></div>"
},
"extension" : [
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"url" : "https://atrius.in/fhir/r4/atrius-in/PlanDefinition/hf-admission-protocol",
"identifier" : [
{
"use" : "official",
"system" : "https://atrius.in/fhir/sid/cds-service",
"value" : "hf-admission-protocol"
},
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:1.3.6.1.4.1.66219.1.34.8"
}
],
"version" : "0.1.0",
"name" : "AtriusHFAdmissionProtocol",
"title" : "Heart Failure Admission Protocol",
"subtitle" : "ED / inpatient admission pathway for acute decompensated HF",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
"code" : "clinical-protocol"
}
]
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},
"date" : "2026-07-14",
"publisher" : "Atrius",
"contact" : [
{
"name" : "Atrius",
"telecom" : [
{
"system" : "url",
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}
]
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],
"description" : "Person with active heart failure on the chart at encounter start: confirm ED eligibility features, then propose daily weight monitoring, sodium-restricted diet, IV furosemide, and an admission BNP when none resulted in the last 24 hours.",
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{
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"code" : "focus"
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"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "84114007",
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"code" : "ICU",
"display" : "Intensive care unit"
}
]
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}
],
"purpose" : "Standardize safe initial management of acute decompensated heart failure at admission, aligned with AHA/ACC/HFSA guidance, while avoiding redundant natriuretic peptide draws.",
"usage" : "Invoke on encounter-start (ED or inpatient). Complete the eligibility questionnaire when the working diagnosis is acute HF, then review and place the proposed admission actions.",
"copyright" : "© Atrius. Pathway structure is illustrative; institutions must adapt dosing and local formulary.",
"approvalDate" : "2026-07-14",
"lastReviewDate" : "2026-07-14",
"effectivePeriod" : {
"start" : "2026-07-14"
},
"topic" : [
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"code" : "treatment"
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"code" : "84114007",
"display" : "Heart failure (disorder)"
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],
"author" : [
{
"name" : "Atrius Cardiology / Clinical Reasoning"
}
],
"editor" : [
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"name" : "Atrius Clinical Reasoning"
}
],
"relatedArtifact" : [
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"type" : "documentation",
"display" : "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure",
"citation" : "Heidenreich PA, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Circulation.",
"url" : "https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063",
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},
{
"type" : "depends-on",
"display" : "HF admission ED eligibility questionnaire",
"resource" : "https://atrius.in/fhir/r4/atrius-in/Questionnaire/hf-admission-eligibility|0.1.0"
},
{
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"display" : "Atrius HF admission CQL library",
"resource" : "https://atrius.in/fhir/r4/atrius-in/Library/AtriusHFAdmission|0.1.0"
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],
"library" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/Library/AtriusHFAdmission|0.1.0"
],
"goal" : [
{
"id" : "euvolemia",
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/goal-category",
"code" : "safety"
}
]
},
"description" : {
"text" : "Relieve congestion and maintain clinical euvolemia during the admission"
},
"priority" : {
"coding" : [
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"code" : "high-priority",
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"code" : "84114007",
"display" : "Heart failure (disorder)"
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},
{
"id" : "daily-weight-trend",
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{
"system" : "http://terminology.hl7.org/CodeSystem/goal-category",
"code" : "nursing"
}
]
},
"description" : {
"text" : "Document reliable daily weights (same scale, before breakfast) to guide diuresis"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/goal-priority",
"code" : "medium-priority",
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"action" : [
{
"id" : "hf-admission-root",
"prefix" : "1",
"title" : "Heart Failure Admission Protocol",
"description" : "Active heart failure condition on the chart; run eligibility then admission management.",
"priority" : "urgent",
"code" : [
{
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"system" : "http://snomed.info/sct",
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],
"goalId" : [
"euvolemia",
"daily-weight-trend"
],
"trigger" : [
{
"type" : "named-event",
"name" : "encounter-start"
}
],
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql",
"expression" : "HF Admission Applicable"
}
}
],
"input" : [
{
"type" : "Patient",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-patient|0.1.0"
]
},
{
"type" : "Condition",
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-condition-encounter-diagnosis|0.1.0"🔗 ,
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},
{
"type" : "Observation",
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},
{
"type" : "Encounter",
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🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-encounter|0.1.0"
]
},
{
"type" : "QuestionnaireResponse",
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🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-questionnaireresponse|0.1.0"
]
},
{
"type" : "MedicationRequest",
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🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-medicationrequest|0.1.0"
]
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"groupingBehavior" : "logical-group",
"selectionBehavior" : "all",
"requiredBehavior" : "must-unless-documented",
"cardinalityBehavior" : "single",
"action" : [
{
"id" : "hf-admission-eligibility",
"prefix" : "1.1",
"title" : "Confirm ED eligibility",
"description" : "Confirm dyspnea/congestion features and that the working diagnosis is acute decompensated heart failure before placing the admission bundle.",
"priority" : "urgent",
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/Questionnaire/hf-admission-eligibility|0.1.0"
},
{
"id" : "hf-admission-bundle",
"prefix" : "1.2",
"title" : "HF admission bundle",
"description" : "Daily weights, sodium restriction, and IV diuresis for decompensated heart failure. Place all elements together unless contraindicated.",
"priority" : "urgent",
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"groupingBehavior" : "logical-group",
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"requiredBehavior" : "must-unless-documented",
"action" : [
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"id" : "hf-daily-weight",
"title" : "Daily weight (same scale, before breakfast)",
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"goalId" : [
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"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-daily-weight|0.1.0"
},
{
"id" : "hf-low-sodium-diet",
"title" : "Sodium-restricted diet (< 2 g/day)",
"description" : "Dietary order supporting congestion management.",
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-task-low-sodium-diet|0.1.0"
},
{
"id" : "hf-furosemide",
"title" : "Furosemide IV",
"description" : "Initial IV loop diuretic for decongestion; adjust to prior outpatient dose and renal function.",
"priority" : "urgent",
"goalId" : [
"euvolemia"
],
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-med-furosemide|0.1.0"
}
]
},
{
"id" : "hf-admission-bnp",
"prefix" : "1.3",
"title" : "Baseline natriuretic peptide",
"description" : "No BNP or NT-proBNP resulted in the last 24 hours; draw an admission baseline.",
"documentation" : [
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"type" : "documentation",
"display" : "2022 AHA/ACC/HFSA heart failure guideline",
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],
"condition" : [
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}
],
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"selectionBehavior" : "all",
"action" : [
{
"id" : "hf-bnp-order",
"title" : "BNP on admission",
"description" : "Admission natriuretic peptide for diagnosis support and trajectory.",
"definitionCanonical" : "https://atrius.in/fhir/r4/atrius-in/ActivityDefinition/atrius-ad-lab-bnp|0.1.0"
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}